Meningitis outbreak: Tainted meds cost $6.50

Mar. 5, 2013

This photo provided Oct. 9, 2012, by the Minnesota Department of Health shows shows vials of the injectable steroid product made by New England Compounding Center implicated in a fungal meningitis outbreak that were being shipped to the Centers for Disease Control and Prevention in Atlanta from Minneapolis. About 17,700 single-dose vials of the steroid sent to 23 states have been recalled. The outbreak involves 10 states, including Minnesota. (AP Photo/Minnesota Department of Health) ORG XMIT: CER102 / AP

Written by

The Tennessean

Saint Thomas Outpatient Neurosurgical Center paid a compounding pharmacy $6.50 a dose for the steroid medications blamed for making dozens of its patients sick and causing meningitis deaths, according to a new court filing.

An amended complaint filed Tuesday includes the clinic’s invoices from New England Compounding Center for 80 mg vials of preservative-free methylprednisolone acetate — a generic version of the brand-name drug Depo-Medrol. The court papers allege price was “the only motivation” for the pain clinic to make bulk purchases of the generic drug from the compounding pharmacy.

The clinic has yet to file an answer to the allegations made in the complaints, which give only one side of a legal dispute.

New England Compounding, which had a history of regulatory violations, shut down after inspections by the U.S. Food and Drug Administration and the Massachusetts Board of Pharmacy documented multiple safety concerns, including dirty equipment.

Attorneys William Leader and George Nolan assert that other compounders charged more for the drug in the amended complaint they filed on behalf of Fred May and his wife, Loduska May of Murfreesboro. Fred May contracted fungal meningitis after undergoing multiple epidural steroid injections last summer — procedures that cost him as much as $1,000.

Drug prices can fluctuate due to supply and demand, but $6.50 per dose is less than some other pain clinics reported they were paying when the meningitis outbreak occurred. Dr. Tim Smyth, a Johnson City anesthesiologist, told The Tennessean last October that he typically paid between $15 and $20 for the compounded version of the drug, which was about half the rate of brand-name medication.

The amended complaint also added a new defendant, Saint Thomas Hospital — a half owner of the clinic. The original defendants in the case were the pain clinic and Howell Allen Clinic, the clinic’s other half owner.

The lawyers contend that the clinic is an agent of the hospital because they share a common name and the clinic is located on the hospital campus.

“Fred May relied on the reputation of Saint Thomas Hospital when accepting care at Saint Thomas Neurosurgical,” the complaint states.

The hospital on Tuesday issued a statement in response to the Reed suit.

“Ms. Reed was first seen at Saint Thomas Hospital when she arrived at the emergency room on Sept. 23, 2012, and reported a severe headache similar to ones she experienced when she had meningitis in the 1980s,” said Rebecca Climer, a hospital spokesperson. “She was admitted to Saint Thomas Hospital where she received the best treatment available under guidance of specialists, which was consistent with the applicable standard of care. Unfortunately, her condition deteriorated and she passed away on Oct. 3.

“As Ms. Reed was receiving treatment at the ambulatory surgery center and later the Saint Thomas Hospital, state and national health authorities were urgently trying to identify what was eventually determined to be an unprecedented health outbreak caused by a contaminated medicine from the New England Compounding Center. The fault lies with the New England Compounding Pharmacy, which failed to follow applicable laws and regulations to ensure the sterility of the medicine they compounded, manufactured and distributed to more than 500 doctors and clinics across the country, including the surgery center.

“Saint Thomas Hospital relied on the Tennessee Department of Health’s directives and guidance and fully cooperated with the department as it established appropriate control measures and investigated the outbreak.”